“Your problem is that you think you have time.”
Carlos Castaneda

Whenever I work with clients, one of the first things I do is get them to complete their end-of-life documents or clarify them. It never ceases to amaze me who has yet to do theirs — attorneys, physicians, and folks with terminal illnesses have all put it off.

It seems to be part of our American culture; if we just don’t think about it, death won’t happen. Yet, we will die. And when we can set up dying on our own terms, it becomes a little bit easier for everybody.

Basic end-of-life documents include: your will, your power of attorney for financial matters, your advanced medical directives and your medical power of attorney.

Depending on your situation and in which state you live, there might be a number of other documents and forms to complete. While it might seem easier and less expensive to get everything done online — not a bad way to start — I always recommend seeing an attorney.

Many have a “package” price for the basics. Getting it done right the first time around will save you and your loved ones drama and cash. Here are a few pointers:

Do your directives now. NOW.

Get out your calendar and schedule when you will start. Yes, it is a project. It will take some time and money. For many, though, the hardest part is having this conversation with yourself, clarifying and discerning what it is you need and want.

Choose your medical power of attorney wisely.

I can’t say this loudly enough. It’s not OK to have someone who you think might follow your wishes. You need to have someone who absolutely will and is willing to be an advocate for you against all others and odds.

I had a client who thought her medical power of attorney (fiancé) was “starting to come around” to her wishes. If she had a terminal diagnosis, she did not want extraordinary measures taken.

It was all clearly and legally stated; she had reviewed everything with her family, and they were on board. I warned her that if something horrible happened, her directives may not be followed if he hadn’t yet “come around.”

Shockingly, a terrible tragedy did ensue, and she ended up on a ventilator in the ICU because her medical power of attorney insisted that she stay alive — he had financial motivations — in spite of her documented wishes and her family’s unequivocal support of them.

Ethics and legal teams were summoned. Fortunately, she died within a day of being imprisoned there, but the trauma of this sorrowful event still reverberates in all of us she left behind.

Once you’ve got everything wrapped up, let your wishes be known.

While it may not be comfortable, have “the conversation” with your loved ones. Make sure your physician has a copy of your medical directives, that your medical power of attorney has a copy of your medical directives, and that your executor has a copy of everything as well as your attorney.

Be clear who has the original documents — safeguard these! — and label them as such.

If you have a Do Not Resuscitate (DNR) order, post it on your refrigerator door where emergency medical personnel can see it — they will look for it there if they have to come to your home.

In an emergency situation, though, I need to warn you it can get tricky. First of all, most of us don’t carry our medical directives around with us wherever we go.

Technology is beginning to address this issue. Emergency personnel default to full resuscitation unless you’ve got contradictory requests clearly documented and instantly available. Even then, I know of people with DNR tattooed on their chest who were fully resuscitated — against their wishes.

Emergency personnel in multiple states have told me that even when the patient has clearly stated in their medical directives that they do not want to be kept alive, if a family member is there begging them to keep their loved one alive, they will follow the family’s wishes against the medical directive. Likewise in the hospital setting.

I’ve asked estate and elder law attorneys, also in multiple states, how can this be? After all our hard work setting things up so that our dying goes according to our wishes, only for it to unravel at the end?

They point out the difference between legality and reality. The short answer: no healthcare provider or organization wants to be sued.

So, even if we’ve done everything right, put all in order with i’s dotted and t’s crossed, ultimately, we must let go. We’ll die as we’ll die and maybe not quite like we planned.

Doesn’t the very nature of death demand we release our grip and relentless need to control? In the end, we must let it be.